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Covered Fertility Benefits
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WIN has spent the last six years developing its comprehensive set of covered
medical benefits for infertility treatment. The covered medical benefits have
been carefully designed to align the incentives of patients, providers,
employers, and health plans to improve outcomes and minimize costs.
Furthermore, this benefit design specifically addresses the challenges facing
patients, employers and health plans regarding high order multiple births, its
clinical impact on mothers and children, and the extraordinary costs associated
with obstetrics, neonatal and chronic care. Depending on health plan design,
state mandates or other limitations WIN will make appropriate adjustments to
the covered medical benefits and corresponding pricing.
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Similar
to our covered medical benefits, WIN’s covered pharmacy benefits have been
carefully designed to align the incentives of patients, providers, employers,
and health plans to improve outcomes and minimize costs. Depending on health
plan design, state mandates or other limitations WIN will make appropriate
adjustments to the covered pharmacy benefits and corresponding pricing.
Pharmaceutical Coverage includes all infertility specific injectables and
medications that are prescribed by WIN Participating Providers and are subject
to all WIN policies and procedures including prior authorization and
precertification.
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